Transformation to a curable infection? The problem with the current strategy, antiretroviral drug therapy, for HIV infection is that it only kills the virus when it is replicating, but a large pool of dormant infected cells in the infected patient’s body lie in wait. These periodicaly get reactivated and produce fresh virus. Thus, unless every last dormant HIV-containing cell is destroyed, the patient must take antiretroviral therapy for life to address any potential future recurrence of active infection.
Now it turns out that one of our mainstay anticonvulsant medications, depakene, is markedly effective at eradicating dormant HIV-infected cells. In the current study, three of four patients given standard concentrations of depakene for three months showed an average 75% reduction in the size of the pool of infected dormant cells. So far there is no good explanation fo why this should work, but there’s no looking a gift horse in the mouth in AIDS research. Finding strategies that work against the ‘dormant pool’ is a preoccupation of AIDS researchers these days, now that they’ve got the hang of current antiretroviral therapies; I think what researchers must be doing is throwing all sorts of pharmacological agents at the problem in hopes that something will serendipitously prove effective and safe, as depakene seems to promise to be.
As a psychiatrist, I am intrigued by this finding because there is a pool of HIV-infected patients who have already been receiving therapeutic doses of depakene for many years; namely, those HIV (+) patients who have bipolar mood swings or any of a variety of other conditions with mood lability or instability I treat. (Apart from those who come by their HIV infection and their mood instability independently, the infection itself can promote an organic mood disorder. I was for a time earlier in my career the psychiatric consultant to a major urban HIV clinic, so I have seen many such patients.) Depakene and its derivatives are mainstay mood stabilizers in the psychiatric pharmacopoeia. Furthermore, I am sure there are a significant number of HIV (+) patients who receive depakene for seizure disorders, either related or not to their immunodeficiency disease. Someone ought to look back at the depakene-receiving patients’ viral loads and survival rates as compared with those receiving different mood stabilizers, other psychiatric therapies or no psychopharmacological therapy at all.
